OBJECTIVE: To examine the value of programmed electrical stimulation of the heart in predicting sudden death in patients receiving amiodarone to treat ventricular tachyarrhythmias after myocardial infarction. DESIGN: Consecutive patients; retrospective study. SETTING: Referral centre for cardiology, academic hospital. PATIENTS: 106 patients with ventricular tachycardia (n = 77) or ventricular fibrillation (n = 29) late after myocardial infarction. INTERVENTIONS: Programmed electrical stimulation was performed while on amiodarone treatment for at least one month. MEASUREMENTS AND MAIN RESULTS: In 80/106 patients either ventricular fibrillation (n = 15) or sustained monomorphic ventricular tachycardia (n = 65) was induced. After a mean follow up of 50 (SD 40) months (1-144), 11 patients died suddenly and two used their implantable cardioverter debfibrillator. By multivariate analysis two predictors for sudden death were found: (1) inducibility of ventricular fibrillation under amiodarone treatment (P << 0.001), and (2) a left ventricular ejection fraction of < 40% (P < 0.05). The survival rate at one, two, three, and five years was 70%, 62%, 62%, and 40% respectively for patients in whom ventricular fibrillation was induced, and 98%, 96%, 94%, 94% for patients with induced sustained monomorphic ventricular tachycardia. Where there was no sustained arrhythmia, five year survival was 100%. CONCLUSIONS: In patients receiving amiodarone because of life threatening ventricular arrhythmias after myocardial infarction, inducibility of ventricular fibrillation, but not of sustained monomorphic ventricular tachycardia, indicates a high risk of sudden death.
OBJECTIVE: To examine the value of programmed electrical stimulation of the heart in predicting sudden death in patients receiving amiodarone to treat ventricular tachyarrhythmias after myocardial infarction. DESIGN: Consecutive patients; retrospective study. SETTING: Referral centre for cardiology, academic hospital. PATIENTS: 106 patients with ventricular tachycardia (n = 77) or ventricular fibrillation (n = 29) late after myocardial infarction. INTERVENTIONS: Programmed electrical stimulation was performed while on amiodarone treatment for at least one month. MEASUREMENTS AND MAIN RESULTS: In 80/106 patients either ventricular fibrillation (n = 15) or sustained monomorphic ventricular tachycardia (n = 65) was induced. After a mean follow up of 50 (SD 40) months (1-144), 11 patients died suddenly and two used their implantable cardioverter debfibrillator. By multivariate analysis two predictors for sudden death were found: (1) inducibility of ventricular fibrillation under amiodarone treatment (P << 0.001), and (2) a left ventricular ejection fraction of < 40% (P < 0.05). The survival rate at one, two, three, and five years was 70%, 62%, 62%, and 40% respectively for patients in whom ventricular fibrillation was induced, and 98%, 96%, 94%, 94% for patients with induced sustained monomorphic ventricular tachycardia. Where there was no sustained arrhythmia, five year survival was 100%. CONCLUSIONS: In patients receiving amiodarone because of life threatening ventricular arrhythmias after myocardial infarction, inducibility of ventricular fibrillation, but not of sustained monomorphic ventricular tachycardia, indicates a high risk of sudden death.
Authors: A R Willems; J G Tijssen; F J van Capelle; J H Kingma; R N Hauer; F E Vermeulen; P Brugada; D C van Hoogenhuyze; M J Janse Journal: J Am Coll Cardiol Date: 1990-09 Impact factor: 24.094
Authors: H L Waxman; W C Groh; F E Marchlinski; A E Buxton; L M Sadowski; L N Horowitz; M E Josephson; J A Kastor Journal: Am J Cardiol Date: 1982-11 Impact factor: 2.778
Authors: J J Heger; E N Prystowsky; W M Jackman; G V Naccarelli; K A Warfel; R L Rinkenberger; D P Zipes Journal: N Engl J Med Date: 1981-09-03 Impact factor: 91.245
Authors: L N Horowitz; A M Greenspan; S R Spielman; C R Webb; J Morganroth; H Rotmensch; N M Sokoloff; A P Rae; B L Segal; H R Kay Journal: Am J Cardiol Date: 1985-02-01 Impact factor: 2.778